Legislators focus on eye war

Besides the governor and the wealthy, the group most disappointed that the legislative debate over income tax repeal ended before it began were contract lobbyists. Many were signed up by businesses and trade groups to try to protect various exemptions or to avoid sales taxes on services. But after the whole matter was junked so early, many governmental consultants feared for a session lacking clients with issues.

Then along came the eye doctors. An all-out legislative battle over optometrists wanting to do some procedures that only ophthalmologists are now allowed to do has both sides lobbying up for a showdown in the House of Representatives.

Scheduled for debate on Wednesday is House Bill 527 that would allow optometrists to perform certain surgical procedures on eyes and eyelids - at times using scalpels or needles - and to prescribe many drugs, including painkillers.

Licensed optometrists go through four years of optometry school, not medical school, before being certified by their own state board. They prescribe glasses and contact lenses and diagnose disorders, but, for nearly all surgical procedures, they must refer patients to ophthalmologists, who are medical doctors.

Many rural parishes have no ophthalmologists, causing patients to have to travel to the larger cities for eye surgery. Testifying before the House Health Committee last week, optometrists framed the issue as one of access to affordable care, saying said patients often delay or forgo treatment because of having to travel. Even then, some low-income patients have trouble finding ophthalmologists who accept Medicaid.

The physicians, wearing lab coats with red patches reading "Oppose 527," filled up the committee room and took up most of the time for testimony to state their opposition.

One after another described their training of four years of medical school, an internship and three years of residency, involving thousands of clinical hours spent observing and practicing. To open up surgery to optometrists, they said, would diminish the standard of care and endanger patients.

Optometrists pointed to the restrictions in the bill that would keep them from doing major surgery, including LASIK. They characterized the procedures they seek to perform, some of which they now can in emergencies, as "minor surgery."

To which one ophthalmologist responded, "There is no such thing as minor surgery when it's being done on you."

In real life, many optometrists and ophthalmologists work well together. In the political arena, however, there is a history of friction between the two groups, just as medical doctors, over the years, have opposed the efforts of chiropractors, podiatrists, psychologists and nurses to expand their services.

If the committee members, some of glazed eye, looked as though they had heard it all before, it's because they had, from both sides, in the two weeks leading up to the meeting. After two hours of testimony, the ophthalmologists in the audience felt they had won the argument, but they were disappointed that the optometrists carried the committee, which approved the bill, 12-7.

The optometrists' time spent on political activity apparently served them well, for they had lined up nine of the 17 committee members as co-authors well in advance. But with the bill before the House, the greater resources of the medical doctors are coming to bear, including radio commercials warning that state legislators could follow the lead of California politicians, who are considering the same legislation.

Some citizens will find it alarming that legislators get to set the boundaries of medical practice. But some legal body has to, and, over time, the Louisiana Legislature has been more conservative than most on scope-of-practice issues. The legislative process can settle this. With so much information and argument from both sides, when it comes to commanding lawmakers' attention, the eyes have it.

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Email this article

Legislators focus on eye war

Besides the governor and the wealthy, the group most disappointed that the legislative debate over income tax repeal ended before it began were contract lobbyists.